International journal of psychiatry in medicine
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Int J Psychiatry Med · Jan 2019
Randomized Controlled TrialSocial support deficit and depression treatment outcomes in patients with acute coronary syndrome: Findings from the EsDEPACS study.
This study aimed to investigate whether social support deficit has moderating effects on depressive and cardiac outcomes in an antidepressant trial for depressed patients with acute coronary syndrome as a secondary analysis using Escitalopram for DEPression in acute coronary syndrome study (ClinicalTrial.gov registry number: NCT00419471). ⋯ Evaluation of social support deficit in depressed acute coronary syndrome is important, and particularly during the acute phase, depressed acute coronary syndrome patients with social support deficit should be treated more carefully to improve treatment outcomes, given that social support deficit was predictive of poorer depressive and cardiac outcomes during the 24-week treatment period. Acute coronary syndrome patients with social support deficit should be treated more carefully to improve treatment outcomes.
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The World Health Organization proclaimed in 1948 that "health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." In many underserved communities, the individual and social well-being of patients of color is threatened. The United States is currently experiencing an exacerbation of racial tensions, and as health-care providers, we are dealing with the effects of racism on a daily basis. ⋯ Various viewpoints on racism as a health issue will be offered and will be further clarified by the authors. Collaborators on this project are two underrepresented minority residency program faculty, a resident who is passionate about social justice and who is ethnically different from the majority of his patients, and lastly an international resident of color who has experienced racism directly and indirectly during residency training.
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Int J Psychiatry Med · May 2017
Childhood abuse in adults in primary care: Empirical findings and clinical implications.
In the healthcare setting, adult patients with histories of childhood abuse are of significant concern and are frequently encountered in the primary care setting. However, there is a dearth of studies investigating the relationships between psychopathology, overall health, healthcare utilization, physician ratings of patient difficulty, and childhood abuse. The present study examines these relationships in primary care patients with (N = 45) and without (N = 129) histories of childhood abuse (physical, sexual, and both). ⋯ Overall, these findings suggest that a history of childhood abuse is associated with a host of negative health outcomes. Findings also suggest that negative feelings about a patient may help physicians identify patients with histories of childhood abuse. It is especially important for physicians to routinely include an assessment of childhood abuse during the psychosocial portion of the medical interview or through screening instruments.
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The concept of cultural humility acknowledges the enormous task of becoming culturally competent by encouraging curiosity about the context within which others live. For physicians, this includes curiosity about the organizations in which they work as Outsiders in settings such as a new hospital or patients' homes. However, efforts to train healthcare professionals in cultural competence are often de-emphasized due to the pressure learners feel to acquire Medical Knowledge and clinical skills. ⋯ Participants in this training have improved their ability to recognize when they are Outsiders where they provide care. They have developed a better understanding that cultural humility in organizations is a gateway to providing quality care. They have begun the process of committing to respectfully learn from the organization's Insiders.